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in my experience

In a profession with recruitment and retention difficulties, we need to be proactive in encouraging the right people into the profession. As Lucy Wood found through organising speech and language therapy as a career courses, such efforts also bring personal benefits by reminding us that our work is interesting, varied and challenging.

The right people for the job
everal years ago I took on the role of coordinating observation requests and information to prospective speech and language therapists in addition to coordinating student placements at King’s College Hospital. As well as developing the help we can offer to these people, I have become increasingly aware not only of the importance of being able to offer such help, but also of the associated difficulties for busy services. There seems to be a great variation in the amount and variety of observation that prospective speech and language therapists manage to achieve: some have tried contacting many different services with no success whatsoever; others have been provided with a long, varied and informative programme of observation in their local area. The reported difficulties are mainly as expected: lack of time, caseload pressures, confidentiality and the need to commit to student speech and language therapist training. Whilst these problems are clearly very real it concerns me that, with the profession’s current recruitment and retention difficulties, we need to ensure we are attracting the right candidates for training. Those embarking on a training course should be doing so with as clear and realistic an idea as possible about speech and language therapy, and should be sure that it is the right decision to suit their skills, interests and personality. For this reason it is important that they are able to meet and talk to speech and language therapists and are able to get as broad an idea as possible of the range of work. It is also vital that, as well as promoting the positive aspects of speech and language therapy, we make people aware of the difficulties and frustrations that they might encounter. It is very disappointing to hear about trained speech and language therapists who only stay in the profession for a short time. This is a huge waste of resources, of valuable clinical placements and, not least, of the individual’s time, effort and money. Although, like everyone else, we have time pressures and a primary commitment to our patients, we are lucky at King’s in being a fairly large hospital service, with 15 speech and language therapists and a range of adult specialisms. This has been helpful in organising our two day Speech and Language Therapy as a Career courses.

We have continued to offer a day or half day of observation to local people but cannot accommodate every request, especially as they come from all over London and further afield. The two day courses developed on from shorter, free group sessions we had been running, and were in response to the large number of requests (up to 50 over a year) being made for observation. The first group sessions we ran included talks, videos, displays and the chance to meet several speech and language therapists, but could not accommodate direct observation and, we felt, could not truly represent the diversity within speech and language therapy. To provide a much more thorough introduction, coupled with income generation for the service, I devised a programme for a two day course in Autumn 2000, costing £40.00 per person. As King’s is predominantly an adult service, community colleagues from paediatric and learning difficulties services were also involved. The course included: • an overview of communication and swallowing • an introduction to working in the fields of paediatrics, learning difficulties and adult acquired disorders • information on the Royal College of Speech & Language Therapists, career structure and education

Read this
if you • want to recruit the right people to the profession • cannot accommodate all observation requests • have lost sight of the positive aspects of the profession



in my experience

Figure 1 Pre and post course questionnaire responses
Question 1. How knowledgeable did you feel before the course? 2. How knowledgeable did you feel after the course? 3. How keen were you to study speech and language therapy before the course? 4. How keen were you to study speech and language therapy after the course? 5. How enjoyable was the course? 6. How did the course rate for value for money? Range (out of 10) 1-7 6-9 2 - 10 4 - 10 5 - 10 3 - 10 Average

Figure 2 Most frequently used words
4.7 7.8 7.1 rewarding (17) 8 9.1 8.5 challenging (13) interesting (8) fulfilling (7) excited (6) nervous (5) motivated (4) confident (4) How do you view speech and language therapy as a career? varied (22) How do you feel about studying speech and language therapy? enthusiastic (6)

• Do we do our bit to help people make informed decisions about speech and language therapy as a career? • Do we take opportunities to encourage school children to consider the job? • Do we remember why we joined the profession in the first place?

• a morning of direct observation (each participant in a different setting) with guidance towards observation questions to answer • group discussion about direct observation. Information packs included: • working in different settings • Royal College of Speech & Language Therapists leaflets • leaflets and magazines from relevant charities and organisations • salary scales • reading list • suggestions for voluntary work. The course has been repeated twice, with Autumn courses coming at the best time, when applicants are filling in their forms. In total, 33 people attended the courses. Thirty were female, but only three male (8 per cent). Almost all (26) were considering applying for a postgraduate course, with another five considering a four year course as a mature student. Only two participants were still at school, studying A-levels. This pattern reflects the situation of the people who contact us directly, and continues to surprise me. Perhaps we should be doing much more to publicise speech and language therapy to school pupils or, if a similar pattern also exists for course applications, perhaps education establishments should consider a larger percentage of postgraduate places. Questionnaires were filled in at the end of each course (figure 1), and a follow-up questionnaire sent to the thirteen participants from the first course. Overall feedback was good. All participants felt more knowledgeable about speech and language therapy afterwards, and all but three felt keener to study. The comments of those who became less keen suggested that we had achieved our aim of giving an honest and realistic overview; one person was “surprised by some of

the content [but] glad to make a decision on realistic information.” Another said, “it has completely done its job.” All three rated the course highly for enjoyment and value for money. Interestingly, direct observation was felt to be the most important part of the course, although my own view is that the other information and the discussions were what really helped to give maximum impact and value. However, it is important that showing a range of videoed sessions to groups is acknowledged as being very valuable and counts towards a candidate’s application needs. Appropriate sessions can be shown, with explanations and detailed discussion, in a much more time-efficient way for the speech and language therapist than individual ‘live’ sessions. We also asked for adjectives to describe their feelings about speech and language therapy. The most frequently used words are listed in figure 2.

Personal responses
The range of adjectives was much wider for feelings about studying speech and language therapy than for overall views on speech and language therapy, and ranged from scared and apprehensive to determined, enthusiastic and passionate. This emphasises the differing personal responses to actually being a speech and language therapist and stresses the need to provide potential recruits with information that can really help them to make an informed decision. (It is interesting to note that “badly paid” was used several times at the first course, but not at the second and third, when the regrading exercise was in progress.) Nine of thirteen questionnaires were returned six months after the first course. All but one person had applied to study speech and language therapy (with one person gaining additional experience before deciding) and all of those were offered interviews. One interview was considered

“too late”, but the other seven attended interview and were offered places. This seems like a good success rate, but it isn’t possible to say how much difference the course made - the fact that people were prepared to pay to attend suggests they were already fairly well motivated. Even if you are not in a position to run courses such as the one I have described, there are many other things you can do to help ensure the profession attracts people who are right for the job while minimising the disruption to your department. For example: 1.having a coordinator can help with monitoring and planning 2.developing a departmental policy can help manage a large number of requests (for example, specifying local area or minimum age, if the setting is very acute) 3. taking observers in pairs is more time-efficient 4.showing videos to groups allows for more detailed explanation during the session 5.introducing them to students can provide additional valuable insights. Although each course was time-consuming for me as the organiser, the five King’s speech and language therapists who gave talks, and the speech and language therapists who took individuals on observation, there are personal benefits as well as the benefits to the profession and the speech and language therapy service. I found it motivating to be thinking about and explaining the diversity of speech and language therapy. I think we can sometimes become too aware of the pressures and frustrations of the job and lose sight of some of the positive aspects of working as a speech and language therapist. Lucy Wood is a speech and language therapist and student coordinator at King’s College Hospital, London.